HCIR Management (Healthcare Industry Representative)

Guidelines:

• The perioperative RN must manage the presence of HCIRs in the OR
• A HCIR may be present during an operative procedure under conditions prescribed by the healthcare organization and in compliance with accreditation requirements and local, state, and federal regulations.

Considerations:

• The same key takeaways from the lesson on visitor supervision in the OR apply to HCIR:
  • Must be approved to be in the OR
  • Must maintain compliance with institutional policies
• Additional safeguards for HCIRs per specific healthcare organization policy may include:
  • Informed consent for HCIR to be present during procedure
  • Process for checking in/verifying compliance
  • Process for checking in instruments for reprocessing
  • Process for bringing in new equipment/products

Nurse’s role:

• Advocate for patient safety, privacy, dignity, and confidentiality in all phases of perioperative care
• Verify that loaned instruments have been through the health care organization’s terminal sterilization before use
• Follow facility policy and federal, state, and local regulations for informed consent
• Verify the HCIR is wearing identification, preferably with photo, surgical attire, and PPE
• Monitor the HCIR’s activities and facilitate during the procedure
• Document the HCIR’s presence including name, company, and time in room per organization’s policy

Pitfalls:

• Policies and procedures are specific to healthcare organization policy
• Medical staff is not always aware of policies related to HCIR presence in the OR
• Must maintain patient safety and privacy

Examples:

• A HCIR is in the OR during induction for a surgical case where the surgeon will be using one of their products. What are some potential issues associated with their presence in the OR?
  • Patient safety (noise, distractions, traffic)
  • Patient privacy (exposure, prep, etc.)

Linchpins (Key Points):

• The perioperative RN must manage HCIR presence in the OR
• The perioperative RN must advocate for patient safety
• The perioperative RN must advocate for patient privacy